Death rates in schizophrenic patients are known to be excessive. This has been demonstrated by many investigators in different countries and diverse settings over the past 50 years. Nonetheless, there is little reliable data on risk factors associated with excessive mortality in schizophrenic patients. We propose to correct this through a naturalistic study and following-up using record-linking methodology. We propose to examine the charts of all patients admitted to our hospital between 1970 and 1985 diagnosed as having schizophrenia. DSM III criteria will be used to select the study subjects; all will be subtyped by DSM III, the Tsuang-Winokur criteria, and Andreasen's criteria. Charts will be examined for demographic, clinical, treatment, and outcome data. Deaths during follow-up will be determined using a record-linkage process in which the list of schizophrenic patients is compared with all Iowa death certificates issued between 1970 and 1985. Expected numbers of death will be calculated using mortality tables matched for age, sex and follow-up time based on census and vital statistics data for the State of Iowa. This data will give us an opportunity to study mortality in schizophrenia, and compare numbers of recorded deaths with expected numbers. The influence of various risk factors on mortality can then be determined using appropriate statistical methods.